scholarly journals Risk Factors for Acquisition of Multidrug-Resistant Pseudomonas aeruginosa Producing SPM Metallo-β-Lactamase

2005 ◽  
Vol 49 (9) ◽  
pp. 3663-3667 ◽  
Author(s):  
Simone Aranha Nouér ◽  
Marcio Nucci ◽  
Márcia P. de-Oliveira ◽  
Flávia Lúcia Piffano Costa Pellegrino ◽  
Beatriz Meurer Moreira
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Case Patient ◽  
Case Definitions ◽  
Duration Of Hospitalization ◽  
History Of

ABSTRACT To evaluate risk factors for colonization or infection due to multidrug-resistant Pseudomonas aeruginosa (MDRPa) carrying the bla SPM gene (SPM-MRDPa) among hospitalized patients, we undertook a case control study at a 480-bed, tertiary-care university hospital. Two different case definitions were used. In the first definition, a case patient (SPM case patient) was defined as a patient who had at least one isolate of SPM-MDRPa (14 patients). In the second, a case patient (non-SPM case patient) was defined as a patient who had at least one isolate of non-SPM-MDRPa (18 patients). For each case patient, we selected two controls, defined as a patient colonized and/or infected by a non-MDRPa isolate during the same study period and with the closest duration of hospitalization until the isolation of P. aeruginosa as cases. The use of quinolones was the single independent predictor of colonization and/or infection by bla SPM MDRPa (odds ratrio [OR] = 14.70, 95% confidence interval [95% CI] = 1.70 to 127.34, P = 0.01), whereas the use of cefepime was the single predictor of colonization and/or infection by non-bla SPM MDRPa (OR = 8.50, 95% CI = 1.51 to 47.96, P = 0.01). The main risk factor for MDRPa was a history of antibiotics usage. Stratification of risk factor analysis by a precise mechanism of resistance led us to identify a specific antibiotic, a quinolone, as a predictor for SPM-MDRPa.

scholarly journals Duration of Methicillin-ResistantStaphylococcus aureusCarriage, According to Risk Factors for Acquisition

2006 ◽  
Vol 27 (11) ◽  
pp. 1206-1212 ◽  
Author(s):  
Jonas Marschall ◽  
Kathrin Mühlemann
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
University Hospital ◽  
Modifiable Risk Factor ◽  
Lower Probability ◽  
Increased Risk ◽  
Antibiotics Use ◽  
Definition Of

Objective.To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens.Design.Retrospective cohort study.Setting.A 1,033-bed tertiary care university hospital in Bern, Switzerland, in which the prevalence of methicillin resistance amongS. aureusisolates is less than 5%.Patients.A total of 116 patients with first-time MRSA detection identified at University Hospital Bern between January 1, 2000, and December 31, 2003, were followed up for a mean duration of 16.2 months.Results.Sixty-eight patients (58.6%) cleared colonization, with a median time to clearance of 7.4 months. Independent determinants for shorter carriage duration were the absence of any modifiable risk factor (receipt of antibiotics, use of an indwelling device, or presence of a skin lesion) (hazard ratio [HR], 0.20 [95% confidence interval {CI}, 0.09-0.42]), absence of immunosuppressive therapy (HR, 0.49 [95% CI, 0.23-1.02]), and hemodialysis (HR, 0.08 [95% CI, 0.01-0.66]) at the time MRSA was first MRSA detected and the administration of decolonization regimen in the absence of a modifiable risk factor (HR, 2.22 [95% CI, 1.36-3.64]). Failure of decolonization treatment was associated with the presence of risk factors at the time of treatment (P= .01). Intermittent screenings that were negative for MRSA were frequent (26% of patients), occurred early after first detection of MRSA (median, 31.5 days), and were associated with a lower probability of clearing colonization (HR, 0.34 [95% CI, 0.17-0.67]) and an increased risk of MRSA infection during follow-up.Conclusions.Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.

scholarly journals Metastatic Spreading of Community AcquiredStaphylococcus aureusBacteraemia

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Giovanna Fabio ◽  
Maria Carrabba ◽  
Luca Mellace ◽  
Cinzia Hu ◽  
Diego Spagnoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epidural Abscess ◽  
Tertiary Care ◽  
Skin Lesions ◽  
University Hospital ◽  
Serious Infection ◽  
History Of ◽  
Associated Risk Factors ◽  
Healthcare Associated ◽  
And Control

A 29-year-old woman presented to the Fondazione IRCCS “Cà Granda” Ospedale Maggiore, a tertiary care university hospital in Milan (Italy), with skin lesions, fever, myalgia, joint pain and swelling, and a one-week history of low back pain. The diagnosis wasStaphylococcus aureus(S. aureus) bacteraemia spreading to skin, bones, and joints and a lumbosacral epidural abscess L5-S2. Neither initial focus nor predisposing conditions were apparent. The antibiotic therapy was prolonged for six-weeks with the resolution of fever, skin lesions, articular inflammation, and the epidural abscess. Community-acquiredS. aureusinfections can affect patients without traditional healthcare-associated risk factors, and community acquisition is a risk-factor for the development of complications. Raised awareness ofS. aureusbacteraemia, also in patients without healthcare-associated risk factors, is important in the diagnosis, management, and control of this infection, because failure to recognise patients with serious infection and lack of understanding of empirical antimicrobial selection are associated with a high mortality rate in otherwise healthy people.

scholarly journals Increasing frequency of Pseudomonas aeruginosa infections during tigecycline use

2015 ◽  
Vol 9 (03) ◽  
pp. 309-312 ◽  
Author(s):  
Aysegul Ulu-Kilic ◽  
Emine Alp ◽  
Dilek Altun ◽  
Fatma Cevahir ◽  
Gamze Kalın ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Icu Patients ◽  
Thoracic Drainage ◽  
Tertiary Care Facility

Introduction: The widespread use of tigecycline raises the question of increasing infection rates of Pseudomonas aeruginosa (PA) in ICUs which are not affected by this antibiotic. Objective:  The aim of this study was to determine if treatment with tigecycline is a risk factor for PA infection in ICU patients. Methodology: A retrospective and observational study was conducted at Erciyes University Hospital, Turkey, between 2008 and 2010. The Erciyes University Hospital is a 1300-bed tertiary care facility. The patients included in this study were hospitalized in four adult ICUs. Patients with PA infections (case group) were compared with patients with nosocomial infection other than PA (control group). Results: A total of 1,167 patients with any nosocomial infections were included in the study. Two hundred and seventy eight (23.8%) of the patients had PA infection during their ICU stay. Fifty nine patients (21.2%) in the case group received tigecycline before developing PA infections, which were found to be significantly more frequent than in the controls (p < 0.01). Multivariate analysis showed that risk factors for PA infection were previous tigecycline use (4 times), external ventricular shunt (4.2 times), thoracic drainage catheter (2.5 times) and tracheostomy (1.6 times). Conclusion: Our results contribute to the need for new studies to determine the safety of tigecycline use, especially for the treatment of critically ill patients. Since tigecycline seems to be an alternative for the treatment of multidrug resistant (MDR) microorganisms, rational use of this antibiotic in ICU patients is essential.

scholarly journals Microbial Keratitis Profile at a University Hospital in Hong Kong

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Tracy H. T. Lai ◽  
Vishal Jhanji ◽  
Alvin L. Young
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Hong Kong ◽  
Contact Lens ◽  
University Hospital ◽  
Major Risk Factor ◽  
Sampled Data ◽  
Microbial Keratitis ◽  
Contact Lens Wear

Purpose. To evaluate the recent trends in demographics, risk factors, and microbiological profiles of microbial keratitis at a university hospital in Hong Kong. Design. Retrospective review. Methods. The medical records of 51 patients admitted to the Prince of Wales Hospital for microbial keratitis from January 2010 to June 2012 were reviewed. Demographics, risk factors, clinical features, microbiological results, and treatment were recorded. Data was analyzed and compared to our historical sampled data collected 11 years ago. Results. The mean age of patients was 41.6 ± 20.3 years. Contact lens use was the major risk factor (45%), followed by injury (12%). The culture positive rate was 59%, of which 37% were Gram-positive organisms and 53% were Gram-negative organisms. Pseudomonas aeruginosa (50%) and coagulase-negative Staphylococcus (13%) were the most commonly isolated pathogens. No resistance to fluoroquinolones was identified. Conclusions. Our study showed that contact lens wear remained the major risk factor for microbial keratitis in Hong Kong and Pseudomonas aeruginosa remained the commonest bacterium isolated. This is comparable to our historical data and other studies conducted in East Asia.

scholarly journals Prevalence and Risk Factors of Metallo β-lactamase Producing Pseudomonas aeruginosa and Acinetobacter species in Burns and Surgical Wards in a Tertiary Care Hospital

2012 ◽  
Vol 4 (01) ◽  
pp. 039-042 ◽  
Author(s):  
Simit H Kumar ◽  
Anuradha S De ◽  
Sujata M Baveja ◽  
Madhuri A Gore
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Care Hospital ◽  
Acinetobacter Species ◽  
Carbapenem Resistant

ABSTRACT Introduction: The production of Metallo-β-lactamases (MBLs) is one of the resistance mechanisms of Pseudomonas aeruginosa and Acinetobacter species. There is not much Indian data on the prevalence of MBLs in burns and surgical wards. Materials and Methods: A total of 145 non-duplicate isolates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species, isolated from pus/wound swabs and endotracheal secretions from burns and surgical wards, were tested for MBL production by modified ethylene diamine tetra acetic acid (EDTA) disc synergy and double disc synergy tests. Results: Prevalence of MBLs was 26.9% by both the above tests. All MBL-positive isolates were multidrug resistant. Only 6.06% (2/33) P.aeruginosa and 16.67% (1/06) Acinetobacter species were susceptible to piperacillin-tazobactam and netilmycin, respectively. These patients had multiple risk factors like >8 days hospital stay, catheterization, IV lines, previous antibiotic use, mechanical ventilation, etc. Graft application and surgical intervention were significant risk factors in MBL-positive patients. Overall mortality in MBL-positive patients was 34.21%. Conclusion: Emergence of MBL-producing Pseudomonas aeruginosa and Acinetobacter species in this hospital is alarming, which reflect excessive use of carbapenems and at the same time, pose a therapeutic challenge to clinicians as well as to microbiologists. Therefore, a strict antibiotic policy and implementation of proper infection control practices will go a long way to prevent further spread of MBLs. Detection of MBLs should also become mandatory in all hospitals.

scholarly journals Risk Factors Predicting Mortality in Patients with Lung Abscess in a Public Tertiary Care Center in Karachi, Pakistan

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Shaista Ghazal ◽  
Ashok Kumar ◽  
Binav Shrestha ◽  
Sana Sajid ◽  
Maria Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Blood Sugar ◽  
Alcohol Intake ◽  
Care Center ◽  
Tertiary Care ◽  
Lung Abscess ◽  
Tertiary Care Center ◽  
History Of ◽  
Sugar Levels

Introduction: Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. Methods: A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality. Results: Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients <20 years of age (3/4, 75%). Patients with blood sugar levels of >200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% ( p=0.005) in patients with Hb less than or equal to 10 mg/dL. Conclusions: The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10mg/dl) was statistically significant predictive factor for increased mortality. Keywords: lung abscess; mortality; risk factors.    

scholarly journals Carbapenems for the Treatment of Pneumonia: A literature review regarding resistance, risk factors, and mortality

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Tania R. Amalia ◽  
Eli Halimah ◽  
Riyadi Adrizain ◽  
Miski A. Khairinisa
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Treatment Options ◽  
Tertiary Care ◽  
Simplified Acute Physiology Score ◽  
Resistance Risk ◽  
Failure Assessment ◽  
Care Facilities ◽  
Duration Of Hospitalization ◽  
History Of

Carbapenem is one of antibiotic to treat respiratory infections such as pneumonia that frequently used in tertiary care facilities and started to create resistances. This study aims to review the resistance of carbapenems, assess the risk factors for resistance that leads to mortality, and the more effective antibiotic treatment options to overcome the resistance. Assessment of the use of carbapenems in pneumonia through previous studies were carried out by searching the articles in search engine databases in 2011 to 2021. Articles reporting carbapenems resistance, risk factors, and mortality were selected based on inclusion and exclusion criteria. Of 14 articles included in inclusion criteria, 4 studies reported the occurrence of resistance to gram-negative bacteria such as Acinetobacter aumanii, Pseudomonas aeruginosa, and Klebsiella pneumoniae, and 10 articles reported risk factors and mortality. The risk factors for carbapenems resistance are the history of carbapenems use, duration of hospitalization, use of mechanical ventilation, high Simplified Acute Physiology Score (SAPS) scores, and high Acute Physiologic and Chronic Health Evaluation (APACHE). Carbapenems resistance causes mortality such as septic shock, high Sequential Organ Failure Assessment (SOFA) scores, and elevated risk at > 60 years of age, female sex, and inappropriate choice of antibiotics. The results showed that imipenem has higher resistance than other carbapenems members, the risk factors for carbapenems resistance are dominated by a history of carbapenems use, mortality caused by high score SOFA, and colistin can be the current choice to overcome carbapenems resistance.

scholarly journals Risk Factors of Hepatitis C Virus Transmission

2020 ◽  
Vol 24 (1) ◽  
pp. 37-41
Author(s):  
Maimoona Maheen ◽  
Mehak Ruqia ◽  
Sana Fatima
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Hepatitis C ◽  
Family History ◽  
Dental Treatment ◽  
Tertiary Care ◽  
Previous Surgery ◽  
Cross Sectional ◽  
Ear Piercing ◽  
History Of

Background: Hepatitis C is not only a globally prevalent disease but also a significant cause of death. It has multiple complications ranging from Hepatocellular carcinoma to decompensated liver disease. This study was planned to determine the frequencies of various risk factors in Hepatitis C positive patients presenting to a tertiary care health facility in Rawalpindi.Materials and Methods: This descriptive, cross-sectional study included 394 patients that presented to Liver Centre, Holy Family Hospital during the years 2015 to 2016. All these patients were confirmed cases of Hepatitis C. The data were collected from records of the liver center of Holy Family Hospital, Rawalpindi. Statistical Package for Social Sciences (SPSS), version 23 was used to analyze data, and descriptive statistics were calculated. All patients with any other comorbidity were excluded.Results: Of the 394 patients included in this study, 197 (50%) males and 197(50%) females with an average age of 44.48. Out of these, 143(36.3%) had a history of previous surgery, 65 (16.5%) had a blood transfusion, 165 (42.19%) had a history of dental treatment, and 189(48.0%) had a history of injections (IM and IV). Ninety-two patients (23.4%) had a history of barber shave, four patients (1%) had tattooed, and 83 patients (21.1 %) had a history of ear piercing. Fifty patients (38.2%) had a family history of Hepatitis C. Only 23 (31.2%) patients had only one risk factor, while 271 (68.7%) had more than one risk factor before a diagnosis of disease.Conclusion: The majority of the patients had more than one risk factor, with a history of injection use being the most common (intravenous and intramuscular). It was followed by the history of dental treatment, family history, and history of previous surgery.

scholarly journals Predictive Risk Factors for Post Tonsillectomy Hemorrhage in Children

2021 ◽  
pp. 42-47
Author(s):  
Amrat Kumar ◽  
Ghulam Shabir Mehar ◽  
Junaid Hussain ◽  
Ahmed Ali ◽  
Abdul Waheed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
University Hospital ◽  
Age Group ◽  
Tonsillar Hypertrophy ◽  
Recurrent Tonsillitis ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
History Of ◽  
Predictive Risk

Objective: To assess the risk factors which determine the magnitude of post-tonsillectomy hemorrhage.  Study Design: Prospective cross sectional study. Setting: A study carried out at otolyrangical unit at a tertiary care Isra University hospital Hyderabad, from June 2018 to April 2019. Materials and Methods: 110 pediatric patients age 5-17 years were included in this study. We administrated a structured questionnaire to parents of the patients. We selected cases for tonsillectomy as per criteria of the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS). Those patients with a history of recurrent tonsillitis presented at the otolaryngology department were included. Patients with a history of use of anticoagulant therapy, obstructive sleep apnea, patients with a history of a bleeding disorder, and patients not giving consent were excluded. We diagnosed patients selected for tonsillectomy included with recurrent tonsillitis, peri-tonsillar hypertrophy, and tonsillar hypertrophy. Patients were observed and followed for postoperative hemorrhage. Data were analyzed by using Statistical Package for Social Sciences version 21 (SPSS 21). Results:  Among 110 children included in the study, 41.8% patients were in the age group of 5-10 years, 30% were in the age group of 11-15 years and 28.2% were over 15 years. Among 110 patients 21.8% underwent tonsillectomy were diagnosed as recurrent tonsillitis, 19% were diagnosed as having tonsillar hypertrophy, 40.0% were suffering from both recurrent tonsillitis and tonsillar hypertrophy and 19.2% had peritonsillar hypertrophy. This shows that 14.5% were admitted to the hospital after 1-5 days, 58.1% developed post-tonsillectomy hemorrhage after 6-10 days and 27.2% developed post-tonsillectomy hemorrhage after 10 days. Conclusion: We conclude that age >10 years was significant predictive risk factors for post-tonsillectomy hemorrhage among children who undergo tonsillectomy.

scholarly journals Risk factor and perinatal outcome of preterm delivery in a tertiary care centre in rural Haryana

2020 ◽  
Vol 9 (10) ◽  
pp. 4187
Author(s):  
Sunaina Singla ◽  
Banashree Das
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Delivery ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Preterm Births ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of

Background: Aim of the study was to identify risk factors and to assess neonatal mortality and morbidity associated with preterm delivery in patient attending a tertiary care centre in rural Haryana.Methods: This retrospective cohort study was conducted in Shree Guru Gobind Singh Tricentenary Medical College, over a period of one year (January to December). All pre-term deliveries were included in the study. They were followed up from admission till delivery and till discharge from hospital. Various, parameters like maternal age, associated medical disorder, obstetric complications, gestational age, neonatal mortality, need of neonatal intensive care and condition of baby at discharge were analyzed.Results: In the present study, incidence of preterm deliveries was 16.1%. The most common risk factor found to be history of previous abortion (23.6%), preterm premature rupture of membrane (17.1%), Intra-uterine growth restriction (IUGR) with oligohydramnios (10.5%), hypertensive disorder during pregnancy (5.9%), and antepartum hemorrhage (4.6%). But majority of the patient (56.5%) no cause could be identify. Out of total 160 preterm births 3 were still born and 157 live preterm births, and out of which total Neonatal intensive care (NICU) admission were 60. Mortality rate was 100% in neonate weighing less than 1000 gm and 18% in babies weighing less than 2000 gm.Conclusions: The commonest risk factor for preterm delivery is previous history of abortion and adverse perinatal outcome is inversely proportionate to the period of gestation at the time of delivery. All efforts should be made to prolong the pregnancy beyond 34 weeks by identifying and actively managing the risk factors for better neonatal outcome.

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